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It’s easy to say that we can build on the Affordable Care Act by gradually covering more people and by controlling spending by eliminating waste, but these are wishes, not policies. In most instances, there is no simple patch that would work, but rather most changes increase the administrative complexity, add significantly to the costs, and fall short of fully correcting the specific problems addressed.--Comment from Don McCanne

The February Kaiser Health Tracking Poll asked the public about broad options for changing the health system that are currently being discussed and finds more Americans (36 percent) say policymakers should build on the existing law to improve affordability and access to care than any other option presented. Sixteen percent say they would like to see the health care law repealed and not replaced, 13 percent say it should be repealed and replaced with a Republican-sponsored alternative, and 24 percent say the U.S. should establish guaranteed universal coverage through a single government plan.

As debate continues over the idea of universal coverage through a single government plan, the survey finds the public divided, with half saying they favor the idea and 43 percent saying they oppose it, and some opinions swayed after hearing counterarguments. In addition, majorities of Democrats and independents favor the idea, compared to just 20 percent of Republicans. Most Americans think that if guaranteed universal coverage through a single government plan was put into place, uninsured and low-income people would be better off, but there is little consensus among the public about how it would impact their care personally.

This month’s poll also explores the public’s reaction to a few terms used to describe the idea of expanding health insurance coverage to all Americans. Majorities say they have a positive reaction to the terms “Medicare-for-all” and “guaranteed universal health coverage” and fewer say the same for “single payer health insurance system” and “socialized medicine.” About half (53 percent) of Democrats say they have a very positive reaction to “Medicare-for-all” compared with 21 percent who say the same for “single payer health insurance system.”